This article presents an overview of the current knowledge in conventional and laser-assisted pulp capping, based on different research records. The pulp capping technique is mainly based on the healing ability of pulp tissue. The most obvious reparatory response of the pulp lesion is the formation of tertiary dentin. Moreover, this paper outlines the use of different laser wavelengths in order to improve the outcomes of pulp capping. Laser therapy has proven its effectiveness in pulp capping and vital pulpotomy by its capacity to stimulate the repair dentin formation by the pulp tissue, its ability to decontaminate irradiated surfaces, as well as its pain reducing effect. Three clinical cases are also presented.

Purpose: Temporomandibular joint disorder (TMD) is a collective term used for a number of clinical signs and symptoms that involve the masticatory muscles, the temporomandibular joint (TMJ) and its associated structures. Since TMD is a multifactorial disorder, many modes of management have been reported to be effective in reducing or eliminating patient signs and symptoms (initially pain and clicking). There exists considerable debate, both on the part of the surgeon and the patient, regarding treatment (noninvasive or minimally invasive). These have ranged from occlusal adjustment, splint therapy, arthroscopy, surgery, laser therapy, cryotherapy and acupuncture. Low-level laser therapy (LLLT) has been used for pain control and healing. Use of low-level laser for TMD has been controversial, and shortcomings have been found in previous studies. The aim of this study was to evaluate the effectiveness of LLLT at 980 nm in TMD patients.Materials and Methods: We performed a single-blind clinical trial on 48 TMD patients. Before treatment, all patients were matched based on gender, pain, and clicking. There were no cases of degenerative joint disease (DJD) or parafunction (eg, bruxism) and the patients were otherwise healthy. The patients were randomly divided into experimental and placebo groups. In the study group, the patients were treated with LLL (980 nm, 80 Hz, 6 J) at three points over the TMJ (ie, 2 J per point and 1.5 J at the other sites of muscle pain) for 1 min. In the placebo group, the laser device was adjusted in the same positions but without power emission. Effectiveness of LLLT for pain and clicking in the groups was evaluated immediately, after 2 days, after 4 days, and then at 6 and 12 months using a visual analogue scale. To compare the magnitude of click, the chi-square test was used, and for pain severity the Mann-Whitney U-test was used to analyze the results.Results: The pain severity after treatment on day 4 in the experimental group was 2.4 ± 1.36, which was significantly less than the placebo group's results of 4.4 ± 1.84 (p < 0.001). Click reduction was 23.1% in the placebo group and 76.3% in the experimental group. The results were statistically significant for both pain and clicking without recurrence up to the 2-year follow-up period (p < 0.001).Conclusion: Low-level laser therapy (980 nm) was effective in management of TMD signs and symptoms and induced considerable reduction or elimination of pain severity and clicking. LLL applications can be an effective mode of management for selected patients with TMD.

A variety of lasers has been used for hard tissue procedures in dentistry, with erbium lasers now being accepted as the golden standard for these procedures. This study describes a new, highly accurate and repeatable methodology for measuring ablation rates in hard dental tissue, comparing the performance of the two main erbium wavelengths used, Er:YAG (2940 nm) and Er,Cr:YSGG (2780 nm), and discussing the observed differences between the two types of erbium lasers.

Purpose: This laboratory study aimed to determine whether laser activated fluoride (LAF) therapy of sensitive dentine causes conversion of apatite mineral to fluorapatite ("photonic conversion") and thereby reduces the risk of dental erosion.Materials and Methods: X-ray photoelectron spectroscopy was used to quantify changes in the atomic concentration of the elements fluorine, calcium, oxygen, phosphorus, carbon, nitrogen, and silicon, at five depths up to 52 nm in human dentine slabs with patent dentine tubules, which were either treated with neutral sodium fluoride gel (12,300 ppm) only, untreated, or subjected to laser-activated fluorid therapy (LAF) over a 12-week period.Results: Fluorine to calcium ratios were increased from zero (control) to 0.27 and 0.28 after fluoride gel and LAF, respectively. However, the chemical composition of dentine was affected by LAF, with the altered fluorine binding energy of 684.6 eV corresponding to formation of fluorapatite. No conversion to fluorapatite occurred when fluoride gel was applied under identical conditions but without lasing.Conclusion: Partial conversion of apatite minerals with LAF would contribute to the documented protective effects of LAF against dental erosion, and explains the benefits gained clinically when this treatment is applied to sensitive cervical root surfaces.

Purpose: This in vitro study was designed to morphologically analyze, using ESEM, any differences in the microscopic surface of Class V cavities using rotary diamond abrasive instruments and Er,Cr:YSGG laser.Materials and Methods: Twenty extracted human premolars were used. The teeth were brushed and cleaned under tap water and stored in distilled water at room temperature. The teeth were divided into two groups containing 10 teeth each. Standardized Class V cavities were prepared on the buccal surface of all teeth. Cavities in group 1 teeth were prepared using a high-speed air turbine handpiece. Cavities in group 2 teeth were prepared using an Er,Cr:YSGG laser (Waterlase). The laser emits a wavelength of 2790 nm with a pulse frequency of 20 Hz. The delivery tip was held at a distance of 1.5 mm from the target tissues and used in a back and forth motion.Results: The margins of the cavities prepared by conventional diamond rotary instruments were sharp and more irregular. Smear layer and debris were seen covering the peripheral walls and the depth of the cavity in the rotary preparations. The walls of the cavity prepared by the laser were smooth and the dentinal tubules were not plugged. Ablation of hard tissues was observed in the laser preparations.Conclusion: Dental lasers are highly efficient tools in cavity preparation. Not only are they completely safe, but they also provide better surface morphology, which has characteristic features for better retention of the restorative materials.

In addition to conventional treatment modalities, the use of lasers has been increasingly proposed for the treatment of periodontal and peri-implant infections. A 56-year-old female patient had 5 implants with severe and painful peri-implantitis lesions. Local and systemic anti-infective therapies were performed as an adjunct to mechanical treatment but suppuration still persisted. This condition resolved after 3 treatments with diode laser (810 nm) irradiation (1.0 W, CW). During the operation, 2 failed implants were removed, and Er,Cr:YSGG (2780 nm) laser was used for decontamination of implant sockets (1.0 W, 20 Hz) and implant surfaces (0.5 W, 20 Hz), then the implant sockets were augmented. After ten months, radiographic findings showed bone fill in the area of removed implants and no lesions around remaining implants. Laser decontamination provided us with the opportunity to augment the sites without losing soft and hard tissues.

Odontogenic peripheral myxofibroma or intraoral soft tissue myxofibroma is a rare, slowly growing, benign tumor. Only a few details are available in the literature related to this lesion, as opposed to its counterparts, odontogenic myxomas and odontogenic fibromas. To the best of our knowledge, we present the first case of odontogenic peripheral myxofibroma successfully treated with diode laser (810 nm).

The focus of this review article is on the development of laser technology in our department at the University of Vienna Dental School. Professor Sperr presented this paper upon the occasion of his emeritization.